Provider Demographics
NPI:1013230895
Name:RICHARDSON, CHAUNTEL (FNP)
Entity Type:Individual
Prefix:MS
First Name:CHAUNTEL
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 BROADACRES DRIVE
Mailing Address - Street 2:STE 445
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5968
Mailing Address - Country:US
Mailing Address - Phone:973-661-8300
Mailing Address - Fax:973-661-8333
Practice Address - Street 1:5000 E ARAPAHOE ROAD
Practice Address - Street 2:SOMEREN GLEN
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2302
Practice Address - Country:US
Practice Address - Phone:973-661-8300
Practice Address - Fax:973-661-8333
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO150282163W00000X
COAPN.0996708-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse